Oncology Practice Management ™
PROCESS IMPROVEMENTS TO ENHANCE PATIENT CARE™
www.OncPracticeManagement.com
APRIL 2013
VOLUME 3 • NUMBER 3
Three Steps to Better New Federal Reporting Profiles Reimbursement for Physicians and Hospitals Oncology Practices By Gail Thompson By Elaine Kloos, RN, NE-BC, MBA, and Teri U. Guidi, MBA, FAAMA
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he American healthcare system is clearly evolving. Although dramatic changes are likely, these changes will be neither instant nor universal. Thus, Elaine Kloos to optimize revenue, it remains extremely important to understand the current reimbursement situation.
Step 1. Know Thy Payer There are currently 2 major types of insurance contracts—fee for service and percent of charges. The latter usually only exists for hospitals. To achieve optimal reimbursement under either type of contract, the provider must understand the payer’s rules and policies. Edits. These rules, established by the Continued on page 10
Orlando, FL—At the Community Oncology Alliance (COA)’s 2013 annual conference on March 22, 2013, David Eagle, MD, from Lake Norman Hematology Oncology Specialists in North Carolina, presented an illuminating program on the rapid growth of federal reporting on physicians and hospitals in the name of quality. Provocatively entitled, “You Won’t
Believe What CMS Will Be Reporting on Your Oncologists,” Dr Eagle presented the challenges and the details of the information that the federal government is now collecting and reporting. Key federal quality initiatives are now involved in comparing hospitals, comparing physicians, and also building quality and resource-use reports as well as a physician value-based payment modifier. Continued on page 18
Meaningful Use Stage 1 Now Met by Majority of Hospitals By Caroline Helwick
New Orleans, LA—The majority of healthcare “leaders,” primarily hospitals, have qualified for Meaningful Use Stage 1, according to the 24th Annual Health Information and Management Systems Society (HIMSS) Leadership Survey (http://himss.files.cms-plus.com/HIMSS org/Content/files/leadership_FINAL_RE
PORT_022813.pdf.). The survey, released at the HIMSS annual conference, indicates that the government’s efforts to impact provider investments in information technologies (ITs) to qualify for Meaningful Use and International Classification of Diseases, Tenth Revision (ICD-10) conversions are paying off. Continued on page 23
From the publishers of
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of n it o s D ia ter d VI ssocCen vide O Ar i 4 PR y thenceally Ds...3 n a D N ou bity CntinuMea A y T t to mun Coress N h m a g TIE roug Co hatCon A B W
INTEGRATING ONCOLOGISTS, PAYERS, AND THE ENTIRE CANCER CARE TEAM
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